Group risk roundtable: Dealing with absence

• Line managers can be trained to identify the early warning signs of illness, but employers must ensure they do not overburden them with responsibility.

• Creating the right culture using wellness days and stress awareness training can help build more resilient employees and reduce sickness absence.

• The earlier an employee receives appropriate treatment and support, the greater their chances of returning to work

• A collaborative approach to absence, involving insurers and employers, can help establish the right policies and procedures within a workplace in a bid to identify employees’ potential income protection claims as early as possible.

Employee absence is costing UK businesses dear, so employers need to set up systems and processes that can identify the true causes, and provide support to help sick staff return to work quickly, says Sam Barrett

Employers are therefore trying to create a more structured approach to dealing with the underlying issues, with support from group risk insurers, in a bid to keep staff healthy and productive, and ultimately reduce this bill.

Understanding the true causes of absence is crucial, particularly with cases that are not strictly health-related.

Sayeed Khan, chief medical adviser at EEF, says: “In 20 years of doing occupational medicine, I have collected 31 reasons why someone is off sick, of which just one of them is the actual illness,” he says.

“There are lots of other things that influence absence, including the journey into work, whether they do shift work, what their family thinks, what their circumstances are, and sick pay arrangements. A comprehensive understanding of these causes will help employers to tackle sickness absence at an earlier stage.”

Early intervention can help prevent causes of absence spiralling into something more serious, and can potentially reduce the length of time an employee is off work, if not prevent the absence altogether. For example, a worker complaining about a twinge in their back may benefit from an ergonomic assessment of their workstation. This, and any necessary adjustments, could prevent that twinge turning into a real back problem and long-term absence. Likewise, an employee suffering from relationship problems at home could be referred to an employee assistance programme (EAP), providing support to prevent the problem escalating into a long-term stress claim.

Whatever the cause of employee absence, early intervention is key. The sooner an employer understands the true reason for an employee’s absence and, where necessary, helps them to receive treatment for an illness, the better an employee’s chances of returning to work as soon as realistically possible.

Early intervention strategies

To assist employers’ efforts, a number of group risk insurers have beefed up their early intervention strategies over the past decade. Steve Bridger, head of group risk at Aviva UK Health, explains: “It is process-driven at the beginning. We need to know when someone is off, what the trigger is and whether we can help them with any treatment.

“But after that, it’s all about people helping people, working out their issues and motivations and helping them back into work. The longer it takes to get into this, the tougher it gets to return them to work.”

However, product design does not help to speed up the process. Insurers will pay out on a group income protection claim only after a deferred period. Also, employers can take some time to notify their insurer about the prospective claim, during which time an employee’s condition can worsen substantially.

Bridger admits this is a problem for the industry, and he has seen examples of both carrot and stick being used to drive earlier notification. At the stick end, insurers can insert a clause into contracts stating that an employer’s failure to notify the insurer of a claim within double the length of the deferred period can result in the claim not being processed. The typical policy deferral period is six months, so this still gives employers up to a year to report a claim.

Carrots have included the offer of a refund of a proportion of an employer’s policy premium if they notify the insurer about a claim before an agreed deadline.

But Bridger is not convinced that either tactic works, instead preferring a more collaborative approach. “I prefer to get the right engagement early on, so policies and procedures are established with the employer to ensure we are notified of absence at the same time as the employer,” he says.

“This allows us to use early intervention where it is appropriate.”

With the help of adequate training, line managers can play a key role in helping to reduce sickness absence because of their regular contact with employees.

Pressure on line managers

But not everyone thinks employers should put so much pressure on line managers. Bridger says: “Typically, line managers rise through a business, or are brought in to lead and get results from a team. Is it fair to then expect them to be a counsellor and support colleagues suffering with anxiety?

“It can be tough for the line manager. Often they don’t know what to do or say to the employee who is off. We are not looking to turn them into experts, but provide them with enough training and advice to support their team.”

Providing line managers with resources to support staff with issues affecting their work can, Bridger suggests, be a more effective use of their time and talent. These tools include employee assistance programmes, counselling and, for musculoskeletal problems, physiotherapy and referrals to occupational health support.

Of course, line managers themselves can be the cause of employee absence. Sarah Page, research and specialist services officer at Prospect, says: “Training line managers can make a difference, but the experience from one of the fit-note pilots was that a large proportion of the reasons for seeing a [doctor] to talk about absence from work were things such as angst, disagreements and tensions within the workplace.”

Page adds: “Employers need to recognise that the line manager can also be the problem.”

She cites the example of BT, which has designed a system to enable employees to raise with a colleague any concerns they may have about their line manager. Employees are made aware of a line manager, other than their own, with whom they can raise concerns. This process acknowledges that line manager disputes do occur and, at BT, are dealt with.

“It is about more than processes, it is about the culture of the organisation,” says Page. “For example, when it comes to mental health, the employer needs to remove the stigma, so employees feel comfortable raising any problems they may have.”

Create the right culture

Chris Ford, director of group risk at Jelf Employee Benefits, agrees. He believes employers should be taking a more preventative approach to health, to create the right sort of culture. “[Employers] need to have events like stress awareness days to help people who are healthy and in the workplace to become more resilient,” he says. “Engaging with a group risk insurer can help in this respect. Although they are regarded as providing the insurance to protect the bottom line, and therefore outside of the health and wellbeing piece, they can bring all sorts of support to help create the right culture to prevent absence.”

With any absence management strategy, employers must be mindful of an employee’s ability to return to work after long-term absence. Some employees will be able to return to the workplace in a full-time capacity, while others may be advised to opt for a more gradual return, enabling them to build up the strength to cope with the commute and workload involved with a full-time role.

Linda Hilliard, UK reward manager at Informa, says: “It is not always easy to persuade a line manager that an employee should return to work on a gradual basis when they have got to run the department and are trying to hit targets. This can be a challenge.”

Bridger acknowledges the challenge involved, but points out that claims staff are trained to support and help line managers, as well as employees, to ensure a smooth return to work, in whatever form it takes.

Informa UK has introduced return-to-work interviews to tackle absence. “We were able to reduce the sickness absence rates by 50% in one area of the business,” says Hilliard. “It was a small initiative that didn’t cost very much, but it has had a huge impact.”

Flexible working is another solution for managing absence, particularly for supporting an employee who is receiving regular treatment for an illness, or someone dealing with relationship problems.

But Page says: “There is a huge range of options, and many organisations either don’t know what they are or limit them to parents and carers. Opening them up to more people could be incredibly useful and has been shown to deliver a return on investment.”

Bearing all this in mind, it is important for employers to remember that as comprehensive as their efforts may be to prevent sickness absence through a combination of the right culture, well-trained line managers and the appropriate resources and support, some absence is unavoidable.

Nevertheless, the way in which they deal with absence can undoubtedly have a substantial influence on the length of time an employee is off work.